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RK Health Insights 15 April 2016

On 31 March 2016, the Commonwealth Government announced its primary healthcare reforms as part of the Healthier Medicarepackage, containing significant changes to the way Australians with chronic diseases are cared for. The announcement follows an investigation by the Primary Healthcare Advisory Group into how to better care for people with chronic and complex conditions. The changes include better care for people in remote and rural areas, the ability for people to enrol with a local GP to have all their needs managed in one place and a new Medicare payment system.

The initiative is also considering how items on the Medicare Benefits Schedule (MBS) can align with clinical evidence to improve health outcomes. The Medicare Benefits Schedule Review Taskforce is continuing their work in this area.

Additionally, the Commonwealth Government is seeking to clarify Medicare compliance rules and benchmarks by working with clinical leaders and medical organisations.

The Victorian Auditor-General’s recently published Bullying and Harassment in the Health Sector report is critical of the way health sector agencies respond to workplace bullying and harassment and emphases the need for cultural change.

Based on the available evidence, bullying and harassment in the health sector is thought to be widespread. This is reported to have a significant impact on individuals, patients and the health sector in general, including high staff turnover, reduced productivity, difficulties in recruiting and retaining staff, and the potential for significant legal costs and reputational damage.

The Auditor-General concluded that there were a number of factors contributing to issues in the sector. The issues stemmed from the lack of prevention of inappropriate behaviour including a lack of priority being given to reducing bullying and harassment, poor accountability at various levels and poor understanding of the causes, prevalence and impact of the behaviour. The issues continued into the lack of control the agencies had in place to encourage employees to report such behaviour and for management to appropriately respond to inappropriate behaviour.

Numerous recommendations were made including that WorkSafe, the Victorian Public Sector Commission and the Department of Health and Human Services develop an effective sector-wide policy framework, principles and approaches to building positive workplace culture and respectful relationships and that mandatory training is developed and implemented to assist with the prevention, awareness and appropriate response to inappropriate behaviour.

The Australian Charities and Not-for-profits Commission (ACNC) has released a Guidance Note for charity board and committee members outlining the impact of charities operating with a disqualifying political purpose.

The Guidance Note outlines that charities will have a disqualifying political purpose if their purpose is to promote or oppose a particular political party or their candidates, engage in or promote unlawful activities or activities that are contrary to the rule of law, constitutional system, public safety or national security. Charities that are deemed to have a disqualifying political purpose may lose their registration as a charity.

Charities may choose to campaign for public policy, raise awareness of issues and promote or oppose the operation of laws or practices so long as the advocacy is in line with its charitable purpose and complies with the requirements of its governing document and any relevant legislation (for example, the Charities Act 2013 (Cth) and the Commonwealth Electoral Act 1918(Cth)).

The Guidance Note includes a “Frequently Asked Questions” section about advocacy and political campaigning for charities to review for further clarification.

The Australian Health Practitioner Regulation Agency (AHPRA) has released a public report on its activity and performance in all States and Territories covering its progress from October to December 2015.

This will be the first time AHPRA will be providing quarterly reports in addition to the annual report and professional summaries to improve transparency and accountability. The reports illustrate AHPRA and the National Boards’ statistics on the management of applications for registration as a health practitioner, notifications about the health, performance and conduct of registered health practitioners and offences against the National Law and the monitoring of health practitioners and students with restrictions on their registration.

The Minister for Health and the Department of Health and Human Services have commissioned a review into quality and safety systems in Victorian hospitals.

The review follows an investigation into seven avoidable baby deaths at Bacchus March Hospital in 2013 and 2014 which exposed serious failings in both care and clinical governance. The responsible health service (Djerriwarrh) failed to respond appropriately to safety breaches and complaints about the hospital.

The review panel will examine the Department’s role in monitoring safety and quality throughout Victoria’s public hospitals and health services, with a view to recommending ways in which the Department can strengthen its oversight of hospital safety and quality.

The panel also aims to implement strategies to create stronger transparency so the community can be confident that governance arrangements at both the system and hospital level can quickly identify and rectify defects in care.

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